Document Detail

WITHDRAWN: Interventions for early stage Hodgkin's disease in children.
MedLine Citation:
PMID:  18843628     Owner:  NLM     Status:  MEDLINE    
BACKGROUND: Hodgkin's disease is one of the most curable cancers in children, particularly at the early stages. However it is not clear which combinations of treatment strategies are most effective at maintaining high cure rates and minimising long term harmful effects or sequelae of treatment.
OBJECTIVES: To assess the effects of radiotherapy, chemotherapy or combined radiotherapy and chemotherapy on relapse free survival and overall survival rates in children with early (stage I to IIA) Hodgkin's disease.
SEARCH STRATEGY: We searched the Cochrane Library (issue 4, 2001), MEDLINE (1966 to July 2001), EMBASE, Cinahl, Cancer-CD and reference lists of relevant articles. We also handsearched six journals.
SELECTION CRITERIA: Randomised controlled trials of involved field radiotherapy, extended field radiotherapy, anthracycline based chemotherapy regimens, or alkylating chemotherapy agents in children to 19 years of age with Hodgkin's disease.
DATA COLLECTION AND ANALYSIS: Trial eligibility and quality were assessed and study authors were contacted for additional information.
MAIN RESULTS: Four trials involving 334 children were included. It was not possible to combine the outcomes as they covered different treatment regimens. The trials were of variable quality. One trial comparing radiotherapy alone showed no discernible difference in relapse free survival (relative risk 0.73, 95% confidence interval 0.49 to 1.09) or overall survival (relative risk 0.92, 95% confidence interval 0.79 to 1.07) between involved field and extended field radiotherapy. No discernible difference was found between involved field radiotherapy plus chemotherapy and extended field radiotherapy and chemotherapy (based on one small trial). In another trial, involved field radiotherapy plus chemotherapy appeared to increase relapse free survival compared to either involved field or extended field radiotherapy alone, although a discernible difference was found for overall survival. Extended field radiotherapy alone appeared to increase relapse free survival compared to extended radiotherapy plus chemotherapy (relative risk 0.34, 95% confidence interval 0.14 to 0.83) but no discernible difference was apparent for overall survival (based on one trial).
AUTHORS' CONCLUSIONS: There is little evidence from randomised controlled trials to evaluate the consensus approach of short course chemotherapy and local radiotherapy, although no discernible difference in survival was detected between involved field and extended field radiotherapy in one randomised trial.
Gail G Louw; Charles Ross Pinkerton
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Publication Detail:
Type:  Journal Article; Review     Date:  2008-10-08
Journal Detail:
Title:  The Cochrane database of systematic reviews     Volume:  -     ISSN:  1469-493X     ISO Abbreviation:  Cochrane Database Syst Rev     Publication Date:  2008  
Date Detail:
Created Date:  2008-10-09     Completed Date:  2009-01-15     Revised Date:  2013-06-28    
Medline Journal Info:
Nlm Unique ID:  100909747     Medline TA:  Cochrane Database Syst Rev     Country:  England    
Other Details:
Languages:  eng     Pagination:  CD002035     Citation Subset:  IM    
Postgraduate Medical School, Brighton University, Westlain House, Falmer, East Sussex, UK, BN1 9PH.
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MeSH Terms
Antineoplastic Agents / therapeutic use
Combined Modality Therapy
Hodgkin Disease / drug therapy*,  radiotherapy*
Randomized Controlled Trials as Topic
Reg. No./Substance:
0/Antineoplastic Agents
Update Of:
Cochrane Database Syst Rev. 2002;(3):CD002035   [PMID:  12137640 ]

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